TODD E FUNK OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047930363

License Status

NOT RENEWED

Business

First Name

TODD E

Last Name

FUNK

Suffix

Business Name

TODD E FUNK OD

Original Issue Date

06/29/2004

Effective Date

06/29/2004

Expiration Date

03/31/2006

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

05/11/2006